CRYSTAL NICOLE BOHANNON (NPI# 1457738387) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457738387 |
| Entity Type | Individual |
| Full Name | CRYSTAL NICOLE BOHANNON |
| Other Name | CRYSTAL NICOLE BRISTOE |
| Credential | APRN-NP |
| Practice Address |
8111 Bardstown Rd Louisville KY 40291-3441 |
| Mailing Address |
100 E Liberty St Suite 800 Louisville KY 40202-1434 |
| Practice Telephone | 5022317680 |
| Practice Fax Number | 5022318149 |
| Mailing Telephone | 5022317680 |
| Mailing Fax Number | 5022318149 |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2020-06-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 3009368 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100382320 (KOHMG) | 05 |
| Street Address |
8111 BARDSTOWN RD |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40291-3441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639727555 | Allison Roberts | Nurse Practitioner | 8111 Bardstown Rd, Louisville, KY 40291-3441 | 2019-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881117166 | The Degondaba School, Inc. | Day Training, Developmentally Disabled Services | 5110 Stony Brook Drive, Louisville, KY 40291 | 2017-07-19 |
| 1497108278 | Andrea Herndon | Physician Assistant | 10710 Marceitta Ct, Louisville, KY 40291 | 2016-07-18 |
| 1033536602 | Jennifer Rose Fowler | Social Worker | 10300 Brookridge Villeage Blvd., Suite 104, Louisville, KY 40291 | 2014-03-21 |
| 1740602069 | Brittney Tatum | Licensed Practical Nurse | 9500 Glen Trace Ln, Louisville, KY 40291 | 2014-01-07 |
| 1326392895 | Lisa J Fetter | Nurse Practitioner | 6413 Bardstown Rd, Louisville, KY 40291 | 2012-11-05 |
| 1275829137 | Carolyn Estep Book | Counselor | 9612 Farmstead Lane, Louisville, KY 40291 | 2011-06-20 |
| 1023309028 | Julie Klein Hawkins | Pharmacist | 8014 Bardstown Rd., Louisville, KY 40291 | 2011-04-25 |
| 1295872653 | Loving Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9508 Fairmount Rd, Louisville, KY 40291 | 2007-02-01 |
| 1962548198 | Morgan Howard | Chiropractor | 5501 Bardstown Rd, Louisville, KY 40291 | 2007-01-29 |
| 1407992258 | Deanna H Smith | Social Worker | 9409 Cedar Look Drive, Louisville, KY 40291 | 2007-01-29 |
| Find all providers in zip 40291 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841891645 | K Tierney Lanham LLC | Nurse Practitioner | 6431 Regency Ln, Louisville, KY 40207-2309 | 2020-11-06 |
| 1578192274 | Brian W Oliver | Nurse Practitioner | 309 Iola Rd, Louisville, KY 40207-2917 | 2020-04-04 |
| 1942835624 | Rebecca Spicer | Nurse Practitioner | 9805 Scarborough Ave, Louisville, KY 40272-2436 | 2020-03-03 |
| 1487288262 | Centerpointe Health LLC | Nurse Practitioner | 10100 Linn Station Rd, Louisville, KY 40223-3861 | 2020-03-02 |
| 1750914438 | Robin Elizabeth Masters | Nurse Practitioner | 2011 Lake Point Way Ste 202, Louisville, KY 40223-4229 | 2020-02-20 |
| 1629608286 | Meagan Molestina | Nurse Practitioner | 411 E Chestnut St # 4b6b, Louisville, KY 40202-1713 | 2020-01-23 |
| 1255971131 | Casey Lynn Potter | Nurse Practitioner | 411 Eaat Chestnut Street, Level 5a, Louisville, KY 40202-1713 | 2020-01-08 |
| 1487292033 | Norton Children's Medical Group, LLC | Nurse Practitioner | 1930 Bishop Ln Ste 101710, Louisville, KY 40218-1921 | 2019-12-13 |
| 1548803273 | Jessica L Withrow | Nurse Practitioner | 1900 Bluegrass Ave Ste 103, Louisville, KY 40215-1144 | 2019-10-25 |
| 1629627773 | Latonya Renee Banks | Nurse Practitioner | 2210 Buechel Avenue, Suite 105, Louisville, KY 40218-2619 | 2019-09-10 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40291 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.